Hepatitis A infection rate plunges / U.S. vaccine program focusing on kids has major impact, study says

Brad Wible, Los Angeles Times

Published 4:00 am, Wednesday, July 13, 2005

The rate of hepatitis A infections in the United States has shrunk by 76 percent since the beginning of a vaccination program in 1999 targeting children in 17 high-risk states, federal researchers reported today.

The program has driven the rate of infection down to 2.6 cases per 100, 000 people, or 7,653 cases, in 2003, the latest year for which figures are available.

The program's biggest impact has been on children 2 to 9. Their infection rate nationwide has dropped 89 percent in the past six years, from 18.1 cases per 100,000 children to 2 cases. A decline of 84 percent occurred among people 10 to 18.

Hepatitis A is a liver disease that causes fever, nausea, abdominal discomfort and jaundice, the yellowing of the eyes and skin. Symptoms typically last less than two months and rarely lead to death.

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The virus is most commonly spread in poor sanitary conditions through close physical contact with infected persons or feces.

Children are significant promoters of the virus because they frequently carry it without showing symptoms.

Analysis of infection rates in the late 1990s showed that about 65 percent of all cases in the United States were found in 17 states, largely in the West and Southwest.

Hepatitis A vaccinations had been focused on gay men, intravenous drug users, American Indians and overseas travelers.

The geographic analysis showed that the strategy was missing a large group of infections.

The CDC issued a recommendation in 1999 that encouraged routine vaccination of children living in the high-risk states. Although it was a recommendation, some states implemented mandatory vaccination for entry into day care and preschool programs, Wasley said.

Infection rates in the high-risk states are now no different from the rest of the country.